Co-composting of green waste and biogas waste: physical, chemical parameters and quality of ripe compound.

The impact of adding biogas waste (BW) to green waste (GW) composting to increase nitrogen supplementation and improve mature compost quality was investigated. Conducted over 90 days using static windrows, the experiment compared treatments with GW alone (T1) and GW supplemented with BW (T2 and T3). The results showed that the addition of BW increased temperatures, improved the C/N ratio, and expedited the stabilization process compared to T1. Furthermore, the addition of BW led to significant degradation of hemicellulose (up to 39.98%) and cellulose (up to 27.63%) compared to GW alone. Analysis of Fourier-transform infrared (FTIR) spectra revealed the presence of aromatic, phenolic, aliphatic, and polysaccharide structures in the compost, with BW supplementation enhancing these characteristics. Importantly, the germination index (GI) assessment indicated that the compounds produced were not toxic and instead exhibited stimulatory effects on seed germination. Overall, the findings suggest that supplementing GW composting with BW can enhance the quality and efficacy of the composting process, resulting in compost with desirable properties for agricultural use.

A preliminary study of cutaneous wound healing on the upper eyelid in a small Brazilian population using Rhizophora mangle-based cream.

Plants used in traditional medicine offer an affordable new alternative in tissue repair therapy. This study aimed to evaluate the effectiveness of the 5% Rhizophora mangle cream compared to the 5% dexpanthenol cream in healing open surgical wounds on the upper eyelid. A total of 18 patients were submitted to the experiment and divided into 2 groups with 9 patients each who used topically and daily 5% dexpanthenol cream (control group) or 5% R.mangle cream (intervention group) for 7 days. Clinical, morphometric and histomorphometric analyses of wounds and surgical procedures for skin removal were performed. In the morphometric analysis, all wounds treated with R.mangle and dexpanthenol creams showed complete macroscopic scars, without inflammatory signs and infection free. The skin hydration values in pre and post application periods of the cream were 43.82 ± 43.93 and 62.12 ± 67.40 respectively. The histomorphometric study showed lower values of epithelium distance in R. mangle group and higher in dexpanthenol group with significant difference between groups (p < 0.05). The R.mangle 5% cream proved to be effective in healing wounds of human upper eyelid skin with a significant improvement in epithelization compared to dexpanthenol 5% cream.

Viruses as a potential environmental trigger of type 1 diabetes mellitus (Review).

The etiopathogenesis of type 1 diabetes mellitus (T1DM) is a complex multifactorial process that involves an intricate network of genetic, epigenetic, immunological, and environmental factors. Despite the advances in recent years, some aspects of the mechanisms involved in triggering the disease are still unclear. Infections with certain viruses have been suggested as possible environmental triggers for the autoimmune process that leads to selective and progressive destruction of pancreatic ß-cells and insufficiency of insulin production, which is its hallmark. In this review, advances in knowledge and evidence that suggest the participation of certain viruses in the mechanisms of disease initiation and progression are described. It has been accepted that environmental factors, including viruses, can initiate and possibly sustain, accelerate, or slow down the autoimmune process and consequently damage insulin-producing pancreatic ß-cells. Although the role of these agents, especially human enteroviruses, has been exhaustively studied as the most likely triggers of the activation of autoimmunity that destroys pancreatic islets and leads to T1DM, certain doubts remain. Clinical epidemiological and experimental studies in humans and animals provide consistent and increasing evidence that persistent viral infections, especially with human enteroviruses and rotavirus infections, are associated with an increased risk of the disease in individuals genetically predisposed to autoimmunity.

Alteration in the Expression of Circular Rnas and its association with the Development and Progression of Osteosarcoma, an Integrative Review with High Sensitivity Research.

BACKGROUND: Osteosarcoma is the most common primary malignant bone tumor, mainly affecting children, young adults, and the elderly. It is an aggressive cancer with a poor prognosis, exhibiting low survival rates even with standard treatment. Recently, circular RNA molecules capable of influencing gene expression through various functions, with their main role being acting as microRNA sponges and reducing their intracellular expression, have been identified. Recent studies have linked circular RNAs to osteosarcoma development and progression. Therefore, the present study aimed to investigate the alteration in circular RNA expression during osteosarcoma development and progression. METHODS: An integrative literature review was conducted from September 10th to November 12th, 2021, using the following databases: PubMed/MEDLINE, SCOPUS, Web of Science, OVID, and EMBASE. 129 full articles were included in the review. The obtained data were organized using a standardized data collection instrument, which included the following information: altered expression profile of circular RNAs, associated cancer hallmarks, clinical-pathological relationships of circular RNAs, and perspectives on the studied circular RNAs. RESULTS: A total of 94 distinct circular RNAs were identified, predominantly showing an increased expression pattern. Approximately 91% of the studies that aimed to identify the mechanisms of action of circular RNAs highlighted the function of circular RNAs as microRNA sponges. The most associated cancer hallmarks with the identified circular RNAs were proliferative signaling induction, invasion and metastasis, and resistance to cell death. The altered expression of these circular RNAs generally correlated with a worse prognosis for patients, as evidenced by clinical features such as shorter survival, advanced Enneking and/or TNM stage, higher incidence of metastasis, larger tumor size, and increased chemoresistance. CONSLUSION: These findings indicate the significance of circular RNA molecules in osteosarcoma carcinogenesis, suggesting their potential as new prognostic and/or diagnostic biomarkers, as well as alternative therapeutic targets in the fight against osteosarcoma.

Long-read sequencing genome assembly of Ceratocystis fimbriata enables development of molecular diagnostics for sweetpotato black rot.

Ceratocystis fimbriata is a destructive fungal pathogen of sweetpotato (Ipomoea batatas (L.) Lam.) that leads to losses at all stages of sweetpotato production. Accurate detection of C. fimbriata would allow for more efficient deployment of management tactics in sweetpotato production. To develop a diagnostic assay, a hybrid genome assembly of C. fimbriata isolate AS236 was generated. The resulting 31.7 MB assembly was near-chromosome level, with 18 contigs, 6,481 predicted genes, and a BUSCO completion score of 98.4% when compared to the fungi-specific lineage database. Additional Illumina DNA reads from C. manginecans, C. platani, and a second C. fimbriata isolate (C1421) were then mapped to the assembled genome using BOWTIE2 and counted using HTSeq, which identified 148 genes present only within C. fimbriata as molecular diagnostic candidates; 6 single-copy and 35 highly multi-copy (>40 BLAST hits), as determined through a self-BLAST-P alignment. Primers for PCR were designed in the 200 bp flanking region of the first exon for each candidate, and the candidates were validated against a diverse DNA panel containing Ceratocystis species, sweetpotato pathogens, and plants. After validation, two diagnostic candidates amplified only C. fimbriata DNA and were considered to be highly specific to the species. These genetic markers will serve as valuable diagnostic tools with multiple applications including the detection of C. fimbriata in seed, soil, and wash water in sweetpotato production.

Reversible Tricuspid Regurgitation Due to Beriberi.

We report a case of cardiac beriberi in a 76-year-old man who was hospitalized with a congestive condition of subacute onset, diagnosed as high-output heart failure associated with severe tricuspid regurgitation and indication for caval valve implantation, which, after thiamine replacement, resulted in improvement of all conditions. (Level of Difficulty: Beginner.).

Production of Biodegradable Polymeric Composites with the Addition of Waste.

Several solutions have been presented to minimize the environmental impact generated by polymers produced from petroleum resources. This work produced a biopolymer using glycerol, starch (<5) and macaúba epicarp fiber (10-15-20-25-30%) as reinforcement. The interaction of glycerol with starch was favored by the addition of acetic acid (CH3COOH). The pH was adjusted with sodium hydroxide (NaOH) at a concentration of 0.1 mol·L-1. The characterization was carried out through scanning electron microscopy (SEM), infrared reflectance-FTIR, water solubility, biodegradability and technological properties. Through the results obtained in this work, it is observed that the tensile strength and modulus of elasticity are influenced by the addition of the fiber concentration; the sample that received a 30% addition presented 19.17 MPa and 348.12 MPa, respectively. All samples showed low solubility in water and low density, in addition to a high rate of degradability in soil with mass loss corresponding to 59% over a period of three months. The results of this investigation are satisfactory for the production of materials that can be used in everyday life, replacing conventional plastic.

Distorted thoughts as a mediator of depressive symptoms in patients with major depressive disorder: a longitudinal study.

BACKGROUND: Distorted thoughts are common in Major Depressive Disorder (MDD), and can impact patients' perceptions of depression severity, and predict chronicity and treatment response. This study aimed to investigate whether distorted thoughts mediate depressive symptoms in MDD over a 6-month period. METHOD: These are secondary results from a study that followed 119 patients diagnosed with moderate to severe MDD for 6 months. Diagnoses were confirmed by the Structured Interview for DSM-IV (SCID-CV). The analysis was composed of results from the Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS), the second edition of the Beck Depression Inventory (BDI-II), and the Depression Thoughts Scale (DTS) collected at weeks 1, 8, 12 and 24. RESULTS: Results showed that the DTS mediated the relationship between depressive symptoms experienced approximately 3 months after starting antidepressant treatment. CONCLUSION: Cognitive distortions were linked as a mediator to depressive symptoms, highlighting the importance of early psychological interventions in patients with MDD who exhibit these distortions. TRIAL REGISTRATION: NCT02268487.

A machine learning method integrating ECG and gated SPECT for cardiac resynchronization therapy decision support.

PURPOSE: Cardiac resynchronization therapy (CRT) has been established as an important therapy for heart failure. Mechanical dyssynchrony has the potential to predict responders to CRT. The aim of this study was to report the development and the validation of machine learning models which integrate ECG, gated SPECT MPI (GMPS), and clinical variables to predict patients' response to CRT. METHODS: This analysis included 153 patients who met criteria for CRT from a prospective cohort study. The variables were used to model predictive methods for CRT. Patients were classified as "responders" for an increase of LVEF ≥ 5% at follow-up. In a second analysis, patients were classified as "super-responders" for an increase of LVEF ≥ 15%. For ML, variable selection was applied, and Prediction Analysis of Microarrays (PAM) approach was used to model response while Naïve Bayes (NB) was used to model super-response. These ML models were compared to models obtained with guideline variables. RESULTS: PAM had AUC of 0.80 against 0.72 of partial least squares-discriminant analysis with guideline variables (p = 0.52). The sensitivity (0.86) and specificity (0.75) were better than for guideline alone, sensitivity (0.75) and specificity (0.24). Neural network with guideline variables was better than NB (AUC = 0.93 vs. 0.87) however without statistical significance (p = 0.48). Its sensitivity and specificity (1.0 and 0.75, respectively) were better than guideline alone (0.78 and 0.25, respectively). CONCLUSIONS: Compared to guideline criteria, ML methods trended toward improved CRT response and super-response prediction. GMPS was central in the acquisition of most parameters. Further studies are needed to validate the models.

Feasibility of Left Ventricle Lead Implantation in Cardiac Resynchronization Therapy Guided by Gated SPECT and Ventricular Remodeling. / Viabilidade do Implante de Eletrodo Ventricular Esquerdo na Terapia de Ressincronização Cardíaca Guiada por Gated SPECT e Remodelamento Ventricular.

BACKGROUND: Cardiac resynchronization therapy (CRT) may benefit patients with advanced heart failure (HF). Abnormal eccentricity index by gated SPECT is related to structural and functional alterations of the left ventricle (LV). OBJECTIVE: The aim of this study is to evaluate the feasibility of LV lead implantation guided by phase analysis and its relationship to ventricular remodeling. METHODS: Eighteen patients with indication for CRT underwent myocardial scintigraphy for implant orientation, and eccentricity and ventricular shape parameters were evaluated. P < 0.05 was adopted as statistical significance. RESULTS: At baseline, most patients were classified as NYHA 3 (n = 12). After CRT, 11 out of 18 patients were reclassified to a lower degree of functional limitation. In addition, patients' quality of life was improved post-CRT. Significant reductions were observed in QRS duration, PR interval, end-diastolic shape index, end-systolic shape index, stroke volume, and myocardial mass post-CRT. The CRT LV lead was positioned concordant, adjacent, and discordant in 11 (61.1%), 5 (27.8%), and 2 (11.1%) patients, respectively. End-systolic and end-diastolic eccentricity demonstrated reverse remodeling post-CRT. CONCLUSIONS: LV lead implantation in CRT guided by gated SPECT scintigraphy is feasible. The placement of the electrode concordant or adjacent to the last segment to contract was a determinant of reverse remodeling.

FUNDAMENTO: A terapia de ressincronização cardíaca (TRC) pode beneficiar pacientes com insuficiência cardíaca (IC) avançada. O índice de excentricidade anormal por gated SPECT está relacionado a alterações estruturais e funcionais do ventrículo esquerdo (VE). OBJETIVO: O objetivo do presente estudo foi avaliar a viabilidade do implante de eletrodos do VE guiado por análise de fase e sua relação com o remodelamento ventricular. MÉTODOS: Dezoito pacientes com indicação de TRC foram submetidos à cintilografia miocárdica para orientar o implante, avaliando-se os parâmetros de excentricidade e forma ventricular. P < 0,05 foi adotado como significância estatística. RESULTADOS: Na linha de base do estudo, a maioria dos pacientes foi classificada como NYHA 3 (n = 12). Após a TRC, 11 dos 18 pacientes foram reclassificados para um menor grau de limitação funcional. Além disso, a qualidade de vida dos pacientes melhorou após a TRC. Foram observadas reduções significativas na duração do QRS, intervalo PR, índice de forma diastólica final, índice de forma sistólica final, volume sistólico e massa miocárdica pós-TRC. O eletrodo do VE da TRC foi posicionado concordante, adjacente e discordante em 11 (61,1%), 5 (27,8%) e 2 (11,1%) pacientes, respectivamente. A excentricidade sistólica e diastólica final demonstrou remodelamento reverso após a TRC. CONCLUSÕES: O implante de eletrodo do VE em TRC guiado por cintilografia gated SPECT é viável. A colocação do eletrodo concordante ou adjacente ao último segmento a se contrair foi um determinante do remodelamento reverso.

Biofortification of Kidney Bean (Phaseolus vulgaris L.) Crops Applying Zinc Sulfate and Ferric Sulfate: Pilot Crop in Colombia.

Agriculture is one of the economic activities with the most potential in Colombia, given its climatic and geographical conditions. Bean cultivation is classified as climbing, which grows in a branched way, and bushy, whose growth occurs up to 70 cm. The objective of this research was to study zinc and iron sulfates in different concentrations as fertilizers capable of increasing the nutritional value of kidney beans (Phaseolus vulgaris L.), whose strategy is known as biofortification, and thus determine the most effective sulfate. The methodology details the sulfate formulations, their preparation, the application of additives, sampling and quantification methods of total iron, total zinc, °Brix, carotenoids, chlorophylls a, b, and antioxidant capacity using the DPPH (2,2-diphenyl-1-picrylhydrazyl) method in leaves and pods. As for the results, it was found that biofortification with iron sulfate and zinc sulfate is a strategy that favors the country's economy and human health, because it allows the increase of minerals, antioxidant capacity and total soluble solids.

Improving the performance of machine learning algorithms for health outcomes predictions in multicentric cohorts.

Machine learning algorithms are being increasingly used in healthcare settings but their generalizability between different regions is still unknown. This study aims to identify the strategy that maximizes the predictive performance of identifying the risk of death by COVID-19 in different regions of a large and unequal country. This is a multicenter cohort study with data collected from patients with a positive RT-PCR test for COVID-19 from March to August 2020 (n = 8477) in 18 hospitals, covering all five Brazilian regions. Of all patients with a positive RT-PCR test during the period, 2356 (28%) died. Eight different strategies were used for training and evaluating the performance of three popular machine learning algorithms (extreme gradient boosting, lightGBM, and catboost). The strategies ranged from only using training data from a single hospital, up to aggregating patients by their geographic regions. The predictive performance of the algorithms was evaluated by the area under the ROC curve (AUROC) on the test set of each hospital. We found that the best overall predictive performances were obtained when using training data from the same hospital, which was the winning strategy for 11 (61%) of the 18 participating hospitals. In this study, the use of more patient data from other regions slightly decreased predictive performance. However, models trained in other hospitals still had acceptable performances and could be a solution while data for a specific hospital is being collected.

O papel dos RNAs longos não codificantes na insuficiência cardíaca: uma revisão de literatura / The role of non-coding long RNAs in heart failure: a literature review / El papel de las RNAs largas no codificantes en la insuficiencia cardiaca: una revisión de la literatura

A Insuficiência Cardíaca (IC) é uma das principais causas de internação hospitalar no mundo e tem um elevado grau de morbidade e mortalidade, sendo um grave problema de saúde pública. Os lncRNAs (RNAs longo não codificantes), têm funções regulatórias transcricionais e/ou pós transcricionais bem complexas e que ainda não são totalmente claras, mas que podem exercer influência sobre as doenças cardiovasculares, dentre elas a IC. Assim o estudo teve como objetivo identificar na literatura o papel dos lncRNAs na patogênese da IC por meio de uma revisão integrativa com busca sistemática. Foram considerados elegíveis para leitura e composição do estudo 33 artigos e os principais papéis dos lncRNA na IC foram relatados como possíveis marcadores biológicos para diagnóstico e prognóstico da doença devido a sua expressividade na corrente sanguínea. Além disso, os lncRNAs podem estar relacionados à capacidade funcional uma vez que o aumento ou diminuição de sua expressão promove redução da apoptose de células endoteliais, melhora a disfunção cardíaca, distúrbios de contratilidade e dos canais de cálcio em pacientes com IC. Portanto, os lncRNAs parecem estar envolvidos na patogênese e/ou fisiopatologia da IC, podendo ser utilizados como biomarcadores genéticos com sensibilidade e especificidade semelhantes ou superiores aos empregados atualmente no diagnóstico e prognóstico da IC.

Heart Failure (HF) is one of the main causes of hospitalization worldwide and has a high degree of morbidity and mortality being considered a public health pro- blem. lncRNAs (non-coding long RNAs) have very complex transcriptional and/or post- transcriptional regulatory functions that are still not entirely clear but may influence car- diovascular diseases, including HF. Thus, the study aimed to identify in the literature the role of lncRNAs in the pathogenesis of HF through an integrative review with a systema- tic search. A total of 33 articles were considered eligible for reading and composition of the study. The roles of lncRNA in HF were reported as possible biological markers for the diagnosis and prognosis of the disease due to its expressiveness in the bloodstream. In addition, lncRNAs may be related to functional capacity since the increase or decrease in their expression promotes a reduction in endothelial cell apoptosis, and improves car- diac dysfunction, contractility, and calcium channel disorders in patients with HF. The- refore, lncRNAs seem to be involved in the pathogenesis and/or pathophysiology of HF and can be used as genetic biomarkers with sensitivity and specificity similar or superior to those currently employed in the diagnosis and prognosis of HF.

La Insuficiencia Cardiaca (IC) es una de las principales causas de hospita- lización en el mundo y tiene un alto grado de morbimortalidad considerándose un pro- blema de salud pública. Los lncRNAs (ARN largos no codificantes) tienen funciones re- guladoras transcripcionales y/o post-transcripcionales muy complejas que aún no están del todo claras pero que pueden influir en las enfermedades cardiovasculares, incluida la IC. Así pues, el estudio se propuso identificar en la literatura el papel de los lncRNAs en la patogénesis de la IC mediante una revisión integradora con una búsqueda sistemática. Un total de 33 artículos fueron considerados elegibles para su lectura y composición del estudio. Las funciones de los lncRNA en la IC se señalaron como posibles marcadores biológicos para el diagnóstico y pronóstico de la enfermedad debido a su expresividad en el torrente sanguíneo. Además, los lncRNAs pueden estar relacionados con la capacidad funcional, ya que el aumento o disminución de su expresión promueve una reducción de la apoptosis de las células endoteliales y mejora la disfunción cardiaca, la contractilidad y los trastornos de los canales de calcio en pacientes con IC. Por tanto, los lncRNAs parecen estar implicados en la patogénesis y/o fisiopatología de la IC y pueden ser utili- zados como biomarcadores genéticos con sensibilidad y spe-cificidad similares o superi- ores a los empleados actualmente en el diagnóstico y pronóstico de la IC.

Viabilidade do Implante de Eletrodo Ventricular Esquerdo na Terapia de Ressincronização Cardíaca Guiada por Gated SPECT e Remodelamento Ventricular / Feasibility of Left Ventricle Lead Implantation in Cardiac Resynchronization Therapy Guided by Gated SPECT and Ventricular Remodeling

Resumo Fundamento A terapia de ressincronização cardíaca (TRC) pode beneficiar pacientes com insuficiência cardíaca (IC) avançada. O índice de excentricidade anormal por gated SPECT está relacionado a alterações estruturais e funcionais do ventrículo esquerdo (VE). Objetivo O objetivo do presente estudo foi avaliar a viabilidade do implante de eletrodos do VE guiado por análise de fase e sua relação com o remodelamento ventricular. Métodos Dezoito pacientes com indicação de TRC foram submetidos à cintilografia miocárdica para orientar o implante, avaliando-se os parâmetros de excentricidade e forma ventricular. P < 0,05 foi adotado como significância estatística. Resultados Na linha de base do estudo, a maioria dos pacientes foi classificada como NYHA 3 (n = 12). Após a TRC, 11 dos 18 pacientes foram reclassificados para um menor grau de limitação funcional. Além disso, a qualidade de vida dos pacientes melhorou após a TRC. Foram observadas reduções significativas na duração do QRS, intervalo PR, índice de forma diastólica final, índice de forma sistólica final, volume sistólico e massa miocárdica pós-TRC. O eletrodo do VE da TRC foi posicionado concordante, adjacente e discordante em 11 (61,1%), 5 (27,8%) e 2 (11,1%) pacientes, respectivamente. A excentricidade sistólica e diastólica final demonstrou remodelamento reverso após a TRC. Conclusões O implante de eletrodo do VE em TRC guiado por cintilografia gated SPECT é viável. A colocação do eletrodo concordante ou adjacente ao último segmento a se contrair foi um determinante do remodelamento reverso.

Abstract Background Cardiac resynchronization therapy (CRT) may benefit patients with advanced heart failure (HF). Abnormal eccentricity index by gated SPECT is related to structural and functional alterations of the left ventricle (LV). Objective The aim of this study is to evaluate the feasibility of LV lead implantation guided by phase analysis and its relationship to ventricular remodeling. Methods Eighteen patients with indication for CRT underwent myocardial scintigraphy for implant orientation, and eccentricity and ventricular shape parameters were evaluated. P < 0.05 was adopted as statistical significance. Results At baseline, most patients were classified as NYHA 3 (n = 12). After CRT, 11 out of 18 patients were reclassified to a lower degree of functional limitation. In addition, patients' quality of life was improved post-CRT. Significant reductions were observed in QRS duration, PR interval, end-diastolic shape index, end-systolic shape index, stroke volume, and myocardial mass post-CRT. The CRT LV lead was positioned concordant, adjacent, and discordant in 11 (61.1%), 5 (27.8%), and 2 (11.1%) patients, respectively. End-systolic and end-diastolic eccentricity demonstrated reverse remodeling post-CRT. Conclusions LV lead implantation in CRT guided by gated SPECT scintigraphy is feasible. The placement of the electrode concordant or adjacent to the last segment to contract was a determinant of reverse remodeling.

Is it possible to get COVID infection 3 times? Case report

Rare cases of suspected COVID-19 reactivation have been reported. Reactivation is defined by two positive real-time RT-PCR results for the SARS-CoV-2 virus, with an interval equal to or greater than 90 days between two episodes of COVID-19. A nurse, started with COVID-19 symptoms in July 2020 and a RT-PCR SARS-CoV-2 confirmed the diagnosis. In November 2020, more than 4 months later, she developed a new episode of COVID-19 confirmed by a second RT-PCR SARS-CoV-2. The patient received a first dose of CoronaVac ­ (Sinovac/Butantan) in January 2021 and a second dose in February 2021, but 30 days after a third episode was confirmed. Contrary to what happens with many infectious diseases which generate antibodies and protect people from future episodes, this aspect is still not clear in relation to COVID-19. In addition to vaccination, the use of Personal Protective Equipment is essential for healthcare workers.

Gender Disparity in First and Senior Authorship in Brazilian Cardiology Journals. / Disparidade de Gênero na Autoria Principal e Sênior em Periódicos Brasileiros de Cardiologia.

BACKGROUND: Despite the importance of women in clinical research, no assessment has been made of the fraction of women in a leadership positions in the Cardiology journals of the SBC. OBJECTIVES: To assess the fraction of female authors in the International Journal of Cardiovascular Sciences (IJCS) and the Arquivos Brasileiros de Cardiologia (ABC Cardiol) over the last decades. METHODS: We searched the original articles of the ABC Cardiol, from 2000 to 2019, and of the IJCS, from 2010 to 2019. We surveyed the number of first and senior female authors and the total number of original articles from 2010 to 2019. We calculated the total proportion of female authorship and compared the first quinquennium with the second. Only data from the ABC Cardiol were analyzed to assess the temporal evolution of the two decades. We used the chi-square test to assess the differences within each journal and between them. The IBM® SPSS® software was used in the analyses. The level of significance adopted was 5%. RESULTS: From 2010 to 2019, 1,157 original articles were published in the ABC Cardiol and 398 in the IJCS. We observed that women are more prevalent as first authors in the IJCS compared to the ABC Cardiol, but men prevail as senior authors in both journals. From 2010 to 2019, there was no significant change in the proportion of female authorship. Throughout the decades analyzed for the ABC Cardiol, there was a projection of linear growth of female authorship, with the slope of the line being greater in the first authorship than in senior authorship. CONCLUSIONS: There is gender disparity, with lower female representativeness in authorship in the articles from the Brazilian Cardiology journals analyzed: Arquivos Brasileiros de Cardiologia and International Journal of Cardiovascular Sciences. We believe that based on these results, more efforts should be implemented in the search for gender equity in the cardiology scientific production published by these journals.

FUNDAMENTO: Apesar da importância das mulheres na pesquisa clínica, não existe uma avaliação da fração de mulheres em posições de autoria nos periódicos de cardiologia da SBC. OBJETIVOS: Avaliar a fração de mulheres autoras na International Journal of Cardiovascular Sciences (IJCS) e nos Arquivos Brasileiros de Cardiologia (ABC Cardiol) nas últimas décadas. MÉTODOS: Realizamos busca dos artigos originais dos ABC Cardiol, entre 2000 e 2019, e da IJCS, entre 2010 e 2019. Foi feito levantamento do número de primeiras e últimas autoras e do total de artigos originais de 2010 a 2019. Calculamos as proporções totais de autorias femininas e comparamos o primeiro quinquênio com o segundo. Para avaliar a evolução temporal das duas décadas, analisamos apenas dados dos ABC Cardiol. Utilizamos o teste Qui-quadrado para analisar as diferenças dentro de cada revista e entre ambas. O software IBM® SPSS® foi utilizado nas análises. O nível de significância adotado foi de 5%. RESULTADOS: De 2010 a 2019, foram publicados 1157 artigos originais nos ABC Cardiol e 398 na IJCS. Observamos que as mulheres têm maior predominância como primeiras autoras na IJCS em relação aos ABC Cardiol, mas os homens predominam como últimos autores em ambos. De 2010 a 2019, não houve modificação significativa na proporção de autorias femininas. Ao longo das décadas analisadas para os ABC Cardiol, houve projeção de crescimento linear de autorias femininas, sendo que a inclinação da reta é maior na projeção da primeira autoria que na autoria sênior. CONCLUSÕES: Há disparidade de gênero com menor representatividade feminina nas autorias dos artigos dos periódicos cardiológicos brasileiros analisados: Arquivos Brasileiros de Cardiologia e International Journal of Cardiovascular Sciences. Acreditamos que a partir destes resultados mais esforços devam ser implementados em busca de equidade de gênero na produção científica cardiológica veiculada por estes periódicos.

Disparidade de Gênero na Autoria Principal e Sênior em Periódicos Brasileiros de Cardiologia / Gender Disparity in First and Senior Authorship in Brazilian Cardiology Journals

Resumo Fundamento: Apesar da importância das mulheres na pesquisa clínica, não existe uma avaliação da fração de mulheres em posições de autoria nos periódicos de cardiologia da SBC. Objetivos: Avaliar a fração de mulheres autoras na International Journal of Cardiovascular Sciences (IJCS) e nos Arquivos Brasileiros de Cardiologia (ABC Cardiol) nas últimas décadas. Métodos: Realizamos busca dos artigos originais dos ABC Cardiol, entre 2000 e 2019, e da IJCS, entre 2010 e 2019. Foi feito levantamento do número de primeiras e últimas autoras e do total de artigos originais de 2010 a 2019. Calculamos as proporções totais de autorias femininas e comparamos o primeiro quinquênio com o segundo. Para avaliar a evolução temporal das duas décadas, analisamos apenas dados dos ABC Cardiol. Utilizamos o teste Qui-quadrado para analisar as diferenças dentro de cada revista e entre ambas. O software IBM® SPSS® foi utilizado nas análises. O nível de significância adotado foi de 5%. Resultados: De 2010 a 2019, foram publicados 1157 artigos originais nos ABC Cardiol e 398 na IJCS. Observamos que as mulheres têm maior predominância como primeiras autoras na IJCS em relação aos ABC Cardiol, mas os homens predominam como últimos autores em ambos. De 2010 a 2019, não houve modificação significativa na proporção de autorias femininas. Ao longo das décadas analisadas para os ABC Cardiol, houve projeção de crescimento linear de autorias femininas, sendo que a inclinação da reta é maior na projeção da primeira autoria que na autoria sênior. Conclusões: Há disparidade de gênero com menor representatividade feminina nas autorias dos artigos dos periódicos cardiológicos brasileiros analisados: Arquivos Brasileiros de Cardiologia e International Journal of Cardiovascular Sciences. Acreditamos que a partir destes resultados mais esforços devam ser implementados em busca de equidade de gênero na produção científica cardiológica veiculada por estes periódicos.

Abstract Background: Despite the importance of women in clinical research, no assessment has been made of the fraction of women in a leadership positions in the Cardiology journals of the SBC. Objectives: To assess the fraction of female authors in the International Journal of Cardiovascular Sciences (IJCS) and the Arquivos Brasileiros de Cardiologia (ABC Cardiol) over the last decades. Methods: We searched the original articles of the ABC Cardiol, from 2000 to 2019, and of the IJCS, from 2010 to 2019. We surveyed the number of first and senior female authors and the total number of original articles from 2010 to 2019. We calculated the total proportion of female authorship and compared the first quinquennium with the second. Only data from the ABC Cardiol were analyzed to assess the temporal evolution of the two decades. We used the chi-square test to assess the differences within each journal and between them. The IBM® SPSS® software was used in the analyses. The level of significance adopted was 5%. Results: From 2010 to 2019, 1,157 original articles were published in the ABC Cardiol and 398 in the IJCS. We observed that women are more prevalent as first authors in the IJCS compared to the ABC Cardiol, but men prevail as senior authors in both journals. From 2010 to 2019, there was no significant change in the proportion of female authorship. Throughout the decades analyzed for the ABC Cardiol, there was a projection of linear growth of female authorship, with the slope of the line being greater in the first authorship than in senior authorship. Conclusions: There is gender disparity, with lower female representativeness in authorship in the articles from the Brazilian Cardiology journals analyzed: Arquivos Brasileiros de Cardiologia and International Journal of Cardiovascular Sciences. We believe that based on these results, more efforts should be implemented in the search for gender equity in the cardiology scientific production published by these journals.

[Current and future challenges of the use of precision medicine in cancer diagnosis and treatment in Brazil]. / Desafios atuais e futuros do uso da medicina de precisão no acesso ao diagnóstico e tratamento de câncer no Brasil.

This study seeks to culturally and ethically reflect on the current and future challenges of incorporating new biotechnologies to diagnose and treat cancer in Brazil and assess their impact on cancer control. To this end, this study begins by problematizing the literature on the subject and the results of a study that conducted a web survey with medical specialists from the Brazilian public and private sectors; the latter associated with the ten most representative cancer societies in the country, working in clinical practice, surgery, radiotherapy, pathology, and diagnosis. We discussed this study around three thematic axes: knowledge and expectations on the advent of new technologies to diagnose and treat cancer; structural and ethical considerations in the current and future use of new technologies; and possible scenarios associated with the use and application of new technologies to diagnose and treat cancer. We have raised some questions: will new technological paradigms benefit all Brazilian Unified National Health System (SUS) users, or will they be the privileges of the few? Will they reduce discrepancies regarding the distribution of technological services and resources and cancer diagnosis and treatment? How can different segments of society participate and influence this process? What scenarios can still compose this picture? Aiming to contribute to planning the future of cancer care in Brazil, this study proposes the development of future actions from five strategic dimensions: economy; science, innovation and technology; structure; culture; and regulation.

Este artigo busca refletir, cultural e eticamente, sobre os desafios atuais e futuros da incorporação de novas biotecnologias de diagnóstico e tratamento de câncer no Brasil, bem como seu impacto no acesso e no controle do câncer no país. Para tanto, esta pesquisa parte da problematização da literatura sobre o tema e dos resultados de um estudo, que realizou uma websurvey com especialistas médicos dos setores público e privado brasileiros, associados às dez sociedades oncológicas mais representativas do país, atuantes nas áreas da clínica, cirurgia, radioterapia, patologia e diagnóstico. A discussão do estudo desenvolve-se em torno de três eixos temáticos: conhecimento e expectativas sobre o advento das novas tecnologias para o diagnóstico e tratamento do câncer; considerações estruturais e éticas envolvidas no uso atual e futuro das novas tecnologias; e possíveis cenários associados ao uso e aplicação das novas tecnologias para o diagnóstico e tratamento do câncer. Foram suscitadas algumas questões: novos paradigmas tecnológicos beneficiarão todos os usuários do Sistema Único de Saúde (SUS) ou serão privilégios de poucos? Diminuirão as discrepâncias em termos de oferta de distribuição de serviços, de recursos tecnológicos e de acesso ao diagnóstico e tratamento do câncer? Como diversos segmentos da sociedade poderão participar e influir nesse processo? Que tipos de cenários poderão ainda compor esse quadro? Visando contribuir com o planejamento da atenção ao câncer no Brasil, o artigo finaliza propondo o desenvolvimento de futuras ações a partir de cinco dimensões estratégicas: dimensão econômica; dimensão científica, de inovação e tecnológica; dimensão estrutural; dimensão cultural; e dimensão reguladora.

Este artículo busca reflexionar, cultural y éticamente, sobre los desafíos actuales y futuros de la incorporación de nuevas biotecnologías para el diagnóstico y tratamiento del cáncer en Brasil, así como su impacto en el acceso y control del cáncer en el país. Para ello, parte de la problematización de la literatura sobre el tema y de los resultados de un estudio que realizó una encuesta web con médicos especialistas de los sectores público y privado brasileños asociados a las diez sociedades oncológicas más representativas del país y actuantes en las áreas de clínica, cirugía, radioterapia, patología y diagnóstico. La discusión del estudio se desarrolla en torno a tres ejes temáticos: conocimiento y expectativas sobre el advenimiento de las nuevas tecnologías para el diagnóstico y tratamiento del cáncer; consideraciones estructurales y éticas involucradas en el uso actual y futuro de las nuevas tecnologías; posibles escenarios asociados al uso y aplicación de nuevas tecnologías para el diagnóstico y tratamiento del cáncer. Se han suscitado algunas cuestiones: ¿Los nuevos paradigmas tecnológicos beneficiarán a todos los usuarios del Sistema Único de Salud (SUS) o serán privilegios de unos pocos? ¿Reducirán las discrepancias en la oferta de distribución de servicios y recursos tecnológicos y en el acceso al diagnóstico y tratamiento del cáncer? ¿Cómo los diferentes segmentos de la sociedad podrán participar e influir en este proceso? ¿Qué clase de escenarios todavía podrán componer esta imagen? Con el objetivo de contribuir a la planificación futura de la atención del cáncer en Brasil, el artículo concluye con una propuesta para el desarrollo de acciones futuras desde cinco dimensiones estratégicas: económica; científica, de innovación y tecnología; estructural; cultural; y reguladora.

Desafios no caminho metodológico de construção do processo de Acreditação Institucional de ouvidorias do SUS / Challenges in the methodological path of building the Institutional Accreditation process for SUS ombudpersons

RESUMO O artigo buscou refletir sobre os desafios teórico-práticos enfrentados no caminho metodológico de construção do processo de Acreditação Institucional de ouvidorias do Sistema Único de Saúde (SUS), na elaboração dos materiais pedagógicos e nas dinâmicas de interações fundamentais entre os atores envolvidos. Discorre-se sobre a trajetória de uma parceria de trabalho entre uma equipe de pesquisadores e um departamento do Ministério da Saúde, que visa apoiar teórico-metodologicamente as ações do setor trabalhando os grandes temas da participação e do controle social e, em particular, das ouvidorias, gerando evidências para a tomada de decisões da gestão. São apresentados e problematizados desafios enfrentados no caminho da parceria e do processo de um ponto de vista metodológico, reflexivo e participativo, apresentando-se ideias, noções e conceitos que sofreram evolução, e que presidem os materiais pedagógicos elaborados para instrumentalização do processo de Acreditação Institucional de ouvidorias do SUS enquanto balizamento teórico-prático. Conclui-se que a adoção de um desafiador método de trabalho construtivista e participativo representa um salutar esforço pelo autoaperfeiçoamento e pela garantia da afirmação de valores e princípios democráticos, efetivos na busca constante pela qualificação das ações das ouvidorias, da própria atividade de pesquisa, da prática da gestão e dos serviços e políticas públicas.

ABSTRACT This paper aims to reflect on the theoretical and practical challenges in the methodological path of building the Institutional Accreditation process of the Unified Health System (SUS) ombudspersons, developing teaching materials, and the dynamics of fundamental interactions between the stakeholders involved. It discusses the trajectory of a working partnership between a team of researchers and a department of the Ministry of Health, which aims to theoretically and methodologically support the actions of the sector working on the principal participation and social control topics and, in particular, the ombudspersons, generating evidence for management decision-making. The authors present the challenges in partnership and the process and discuss from a methodological, reflective, and participatory viewpoint, presenting ideas and concepts that have evolved and govern the pedagogical materials prepared for the instrumentalization of the Institutional Accreditation process of SUS ombudspersons as a theoretical-practical framework. The authors conclude that adopting a challenging constructivist method is a healthy effort for self-improvement and guarantee of the affirmation of democratic values, effective in the constant search for the qualification of the actions of the ombudspersons, research activity, management practice, and services and public policies.

Acreditação Institucional de Ouvidorias do SUS: uma análise das experiências iniciais de avaliação externa / Institutional Accreditation of SUS Ombudspersons: An analysis of the initial external evaluation experiences

RESUMO Com base no Curso de Qualificação de Avaliadores Externos para o processo de Acreditação no Sistema Único de Saúde (SUS), realizado em 2018, o objetivo deste artigo foi discutir os desafios postos ao processo de formação desses avaliadores, fundamentado em uma perspectiva da avaliação participativa, como forma de contribuir para aperfeiçoamento de processos dos dispositivos de avaliação externa e autoavaliação. Para isso, analisaram-se 33 documentos produzidos com a prática desses dispositivos no âmbito do projeto. Na avaliação externa, o principal desafio consiste em 'olhar para o outro'; esse tipo específico de olhar exige que a Equipe de Avaliação Externa detenha o domínio sobre os conhecimentos prévios, competências e atitudes necessárias ao trabalho, para captar saberes, intencionalidades e relações, expressos nos atos de fala dos sujeitos. Na autoavaliação, o principal desafio consiste em 'olhar para si'; tomar a si próprio como objeto de conhecimento e campo de transformação requer formas específicas de fazer, visando ao ganho de qualidade nos processos de trabalho. Construir uma cultura de avaliação, em que as informações produzidas subsidiem a tomada de decisão é um desafio para as ouvidorias, que pode ser superado com o Referencial de Qualidade das Ouvidorias do SUS.

ABSTRACT Based on the Qualification course of External Evaluators for the Accreditation process in the Unified Health System (SUS), held in 2018, this paper aims to discuss the challenges to the training process of these evaluators from a perspective of participatory evaluation to contribute to the improvement of external evaluation and self-evaluation devices. To this end, 33 documents produced with the practice of these devices were analyzed within the project. In external evaluation, the main challenge is to 'look at the other'. This specific type of perspective requires the External Evaluation Team's mastery over the previous knowledge, skills, and attitudes necessary for the work to capture knowledge, intentions, and relationships expressed in the statements of the subjects. In self-evaluation, the main challenge is 'looking at oneself'. Taking oneself as an object of knowledge and field of transformation requires specific ways of doing to gain quality in work processes. Building a culture of evaluation in which the information produced supports decision-making is a challenge for the ombudspersons, which can be overcome with the Quality Benchmark of the Ombudsperson Services of the SUS.